Fill in your full name & address and as some words are in Dutch, see here the translations of words:
Betaalopties = Payment options
Eénmalig = Single
2 maandtermijnen = 2 Monthly Installments
Gegevens = Details
Betaalmethode = Payment method
Toevoegen = Add
Winkelmandje = Cart
Ik ga akkoord... = I agree with the order, the details entered by me and the Terms and Conditions.
Afrekenen = Pay
Veilige betaling - Safe payments
And add the 10x recordings if you wish too relisten!